Abstract :
Background: Intrathecal opioids are synergistic with local anaesthetics and intensify the sensory block without increasing the motor block and offer haemodynamic stability. This study was planned to compare the effects of low doses and high dose bupivacaine along with fentanyl citrate.
Methods: This study was carried out in patients presenting for short surface surgical procedures below umbilicus from physical state ASA grade I and II. 60 Patients were randomly allocated in to Group BF 5 [Inj. Bupivacaine Hydrochloride 5 mg Inj. Fentanyl citrate 25 ?g] and Group BF 7.5 [Inj. Bupivacaine Hydrochloride 7.5 mg Inj. Fentanyl citrate 25 ?g] of 30 each. Sensory and motor block were assessed. Patients were observed for both intraoperative and postoperative complications.
Results: Mean levels of sensory blockade to pinprick were T10 in group BF5 and T8 in group BF7.5. Total duration of sensory blockade (175.3 14.56 min) and motor blockade (129.5 19.09 min) were significantly higher in group BF7.5. Hypotension was seen in 7 patients of BF7.5 as compared to just 2 patients in group BF5. None of the patients from either group had bradycardia and respiratory depression. Incidences of shivering, pruritus and headache were similar in both groups.
Conclusion: Both doses of bupivacaine hydrochloride 5 mg and 7.5 mg with fentanyl citrate 25 ?g intrathecally provide successful anaesthesia below T10 spinal segment. However, 7.5 mg dose is associated with denser block, increased incidence of hypotension, delay in achieving highest sensory blockade and delayed recovery which delayed ambulation and discharge time following short surgical procedures.
Keyword :
Bupivacaine, Intrathecal, Opioids, Short surface surgeries below umbilicus